Page 6 - Cover letter and evaluation for Darlene Hoover

compared to those of many other PPO’s, which sometimes charge 40% or more of the
cost of an out-of-network visit to a doctor. In this plan, you will pay $20 to go to an
primary care doctor who is not in the network and $55 to see an out-of-network
specialist. Other out-of-network costs are shown in Appendix D2.

2) The Anthem MediBlue Plus HMO Plan. For an HMO, this plan has a very large provider
network even though it’s not clear how many counties they are spread over. In an HMO,
of course, you will pay full cost if you go to an out-of-network provider unless it’s an
emergency. One potential weakness is this plan’s $4,900 out-of-pocket limit, which is
sub-par for an HMO. This plan’s costs and benefits are summarized in Appendix D3.

As noted earlier, the two that are compared in your husband’s evaluation may also be suitable
choices for you.

Rx Drug Plan Coverage

Your drug costs are low in any of the options, as shown on page 4 of your evaluation. If you
decide to get a Medigap policy and enroll in a Part D stand-alone plan, you will want to enroll in
the Wellcare Value Script prescription drug plan by calling the plan’s toll-free number (888)
293-5151. In this plan, your only cost will be the plan’s $15.50 monthly premium, or $186 a
year. If you get your monthly refills at a CVS pharmacy, there is no charge for monthly refills of
pravastatin, which is a preferred generic drug in this plan’s formulary.

In either of the Advantage plans in the evaluation, your annual costs will be zero if you get your
prescriptions filled at CVS. If you choose one of the two Advantage plans in your husband’s
evaluation, your annual costs will be $24 in either plan.

Darlene, please let me know if you have any questions. On your first visits to your doctors in
2019, show the office staff your enrollment cards for Medicare and your supplemental
coverage. That will help avoid billing confusion. Also, show your pharmacy the enrollment card
for the Part D coverage that you choose. Finally, you are entitled to a free “Welcome to
Medicare” physical after the first of the year, but you’ll probably have to request it.

Sincerely,

David Armes, CFP®

Attachments and appendices
WDA:12115

6